Provider Demographics
NPI:1821845264
Name:SIMMONS, DEBORAH (RN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 W IMPERIAL HWY STE 307
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90303-3141
Mailing Address - Country:US
Mailing Address - Phone:424-541-8254
Mailing Address - Fax:
Practice Address - Street 1:2930 W IMPERIAL HWY STE 307
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303-3141
Practice Address - Country:US
Practice Address - Phone:424-541-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health